Healing Chronic Illness: 11 Tools for Addressing Nervous Systems Perceptions of Threat and Finding YOUR Pathway to Healing (with Covid Updates+)

11 Tools for Healing Chronic Illness

Our bodies have an underlying drive to heal and be well. They also have an innate blue print for health, even when we are sick with a chronic disease. Healing chronic illness from a nervous system perspective supports this powerful mechanism that every body has. I’ve updated this 2015 post of tools for healing chronic illness, added a special new tool to the list, and describe examples of how I’m using these during Covid. My aim is to offer a guide to finding ways to support your own unique journey towards better health, especially during tough times.

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Why These Tools – Which Are Easy to Dismiss – Can Be Life Changing

My focus on treating and healing chronic illness comes from trauma and nervous system perspectives. From seeing symptoms as intelligent processes gone awry, such as because threat responses have gotten stuck in defense mode.

Most of the tools below support and strengthen the social nervous system and its ability to inhibit states of fight, flight and freeze.

Other tools decrease overactive states of fight, flight, freeze and the cell danger response (CDR).

These tools help the body gain more balance balance. Access capacity to take in more support. Grow in more “buffers” that help protect from and reduce effects of adversity and stress.

These are especially helpful during times like we are experiencing during Covid and beyond.

In the face of more buffers – a support network, a set of tools, a sense of more choice, a recognition of our triggers so we can work with them, experiences of pleasure or resource- our bodies gain strength. This helps decrease inflammation and soften and change other survival functions that can drive symptoms.

Just as the effects of stressors and trauma can add up in their effects with time, effects of these 11 tools add up over time too. These tools provide counter-experiences that ALSO add up in their effects. The more tools we have, the more capacity to reduce and counteract the effects of stress and difficulty.

With the state of the world as it is and the added layers of difficulty occurring in our countries, backyards and in our lives – these tools give us seeds to plant for healing chronic illness.

Every tool can help our systems cope in better ways.

How These Tools Can Help

Resources and tools help buffer the effects of current stressors and past trauma. These tools can help:

• gain strength, self compassion and capacity to be with what is happening
• reduce risk of stressful events triggering worsening symptoms
• decrease risk or intensity of new symptoms
• soften or slow rates of worsening when we are already stressed or sick
• stabilize symptoms
• decrease symptoms
• reverse symptoms over time (my story offers one example of healing chronic illness using tools like these)

Decreasing symptoms, risk or intensity of stress helps our bodies carry less stress and have more room to shift out of danger preparedness. It helps our bodies begin to repair and reverse defensive responses that drive symptoms.

For some people, simply making a significant dietary change can be enough to recover from a chronic disease.

For others, implementing mind body practices can lead to improvement or a cure.

Many of us, however, including myself, need to implement more than one of these tools and to keep at it, perhaps for our lifetimes.

What I and many others have found is that it gets easier with time. Our bodies respond to these tools with more ease over time. We also can gain capacity even as we use these tools less (which is what’s been happening for me after using them all and often very intensely for many years).

Are These Tools Enough?

My journey of healing chronic illness includes the fact that I have been able to get good disability coverage. It supported me when I hit rock bottom and has provided me with time and space for healing, slowing down, and paying for therapy and other services, which was rarely covered by my health insurance.

Every human being should have this level of support. It’s what I envision and work for: a trauma informed society. One that recognizes collective, historical and individual experiences of trauma. One that supports healing at all of these levels. One that invests in community, connection, and equality. A society that prioritizes prevention and that provides support for healing emotional health and physical health for all.

Can these tools help even if you don’t have the level of support I do? I believe they can.

Because we are all part of a system, we are affected by the health of our community and any lack of equality and justice for all. As individuals within a system, our own efforts also affect the whole. Everything we do to heal our own trauma and our own lives contributes to healing the whole.

Before I stopped working, I used some of the tools to a degree and was doing trauma therapy to work with my symptoms. I didn’t fully understand these tools or recognize how powerful they were. I was in the early phases of making sense of chronic illness and did not fully grasp the polyvagal nervous system perspectives of how and why their effects could be so deep.

These tools have become part of a big picture for healing chronic illness. They fit into a level of understanding we’re gaining from the research, anecdotes and studies that is changing what we can do to heal. We have more power, choice and control than we’ve realized and that most of our doctors know about.

While our ability to fully invest in these tools is imperfect for many because of time and financial and other constraints, we have more access than we’ve ever known before because of the internet. There are free webinars and videos such as Gwyneth Paltrow’s interview with California’s Surgeon General, pediatrician Nadine Burke Harris. There are free online courses, low cost books and documentaries such as Heal, The Connection, Healing and the Mind, Wrestling Ghosts, and The Dog Doc. There are therapists who offer sliding scales, and more.

Start where you can. Do what you can. These tools can make a difference.

If you’ve experienced a lot of adverse events, have been exposed to many environmental triggers such as mold, toxins, covid or other infections, or have a chronic illness or are a covid long hauler,  it is possible that threat response pathways meant to protect you from harm are already strong and well established. If that’s the case, these tools can make a world of difference.

If you don’t have a chronic illness but feel the effects of the world’s stress and all that is happening, these tools provide layers of support and prevention.

If you now or in the past have experienced significant imbalances with a lot more stressors or traumas and fewer buffers and resources, it can take time to notice improvements. That’s because there are more cell danger pathways and nervous system survival pathways in force.

For all of these situations and more – these tools can help.

How to Use These Tools for Healing Chronic Illness

There is no one size fits all and no fix for everything. You already know this.

The ideal is to therefore use the tools below in any order for treating and healing chronic illness.

The important thing to follow is what calls to you, because intuition and impulse (#2) are indicators of what we love and what our own unique bodies crave or need.

Whether you start big (changing many things at once) or small (starting with baby steps or with one tool) is about what feels good to you, what your body and physiology can handle, and – to repeat – what feels good TO YOU.

Covid Update

During a time like the pandemic, it can be more difficult and feel herculean to implement any or most of these tools. That’s okay. This response happens because lockdowns and local and global events can stimulate threat responses that cause lethargy, fatigue and/ or brain fuzz. They can stimulate survival responses and fear that leave some of us more frustrated, angry and fidgety (fight/flight) while leaving others of us more depressed, immobilized or feeling down (freeze). Many of us experience both.

These are intelligent responses even if they’re unpleasant. Understanding what they are is a place to start.

I’ve been more tired and more easily fatigued since the lockdown here in the US and with the advent of the other big events that have been going on. So I use these trauma perspectives to give myself a context, which reduces my stress and distress and helps me pick and choose what to do and whether to push myself to do more.

Knowing my body is sensitive to stress and doing its best helps me push less. It allowed me to slow down for the month of August when I was feeling good but “full” from zoom interviews in preceding months. It helped me cultivate self compassion, titrate (see #11) by doing less, while observing how this is capacity limit relates to my personal form of response to threat of relative freeze. It also helped me keep going and working with my health as best I could without judging myself.

It helps me keep in mind that healing chronic illness takes time and that it’s okay to go at your pace. That we do the best we can. That adding more tools during intense times can help, even when it’s hard to do more. And that if it’s too much we can also simplify. We can do what you are able to do and possibly a teeny tiny bit more so that we are not completely stuck in threat responses.

Pushing a little can be good. Things that feed and nourish and support help us access and support the vagus branch of our nervous system that best facilitates healing and health.

What feels best for you is one way in which your body communicates how fast and how far to go. It’s information on how to give it what it needs in doses it can work with.

Healing Chronic Illness: Effects are Additive

Each of these tools plants seeds in your garden and on your journey of healing chronic illness.

#1 Make Room for Resources and Pleasure

Learning to recognize and follow impulses for pleasure, play, and rest among others, are keys to activating the calm-connecting, tending-and-befriending aspects of our nervous systems. It seems trivial, yet it is a huge support in health and healing.

Resources provide balance to the ways our brains react and interact with the world, and accessing joy in our lives is an innate and natural way of healing. Acting out is a way of working with your fight and flight energy in pleasurable ways, for example.Even if we can’t do as many things in person right now, there are still ways of resourcing by following impulses to rest, play and connect.

Play and resource reduce ours states of hypervigilance and feelings of despair and hopelessness in manageable ways. This is how healing old wounds supports the process of recovering and healing from chronic illness. See more posts on this topic: Making Time for Resources, and Chronic Illness Christmas Lite.

Covid Update

During the pandemic I’ve resourced myself by working with difficult feelings such as helplessness, grief and rage. Some of this has been through becoming more informed on critical matters such as covid, race and social justice. Stepping towards our rage or discomfort and working with it can be a way we reclaim our power. Some of my work has been by responding or taking action 1 on 1, with individuals, which I’ve realized fits better for me than trying to act as part of a big group. This has lead to some resourcing experiences that feel like I can make contributions in my own small way. These are resources.

I’ve also been resourced by reading more fiction, such as the quirky rom com Big Sexy Love, and heart warming or inspiring nonfiction (such as UnTamed by Glenon Doyle). I’ve watched fewer movies and kept to those that felt gentle, slow, inspiring or comforting (such as Arrival and The Biggest Little Farm). I’ve played a little through painting, a few gentle hikes, and gardening. And I’ve been taking naps more often. All of this has been at a slower pace than usual to give myself room to adjust to the emotional intensity of all that is going on.

#2 Trust Your Intuition and Your Impulses

Our bodies speak through sensation, images, and feelings. Learning to listen to these clues and messages is under-appreciated in our culture, yet it can lead to conversations that lead to insight, self-compassion, and moments of inner calm despite outer chaos. Listening also gives us access to guidance about what to follow and what to leave behind. Intuition is a great help in selecting what tools to try, following feelings such as curiosity that invite us and help us hone in on tools that our bodies crave or are open to experimenting with. Here’s the more detailed post on intuition. It’s called “Intuition, and Why I left Medicine.”

Covid Update

I followed an impulse in February 2020, with careful attention to “checking in with myself” and went to Oregon because I craved an adventure with some alone time and the ocean. I arrived a week before the lockdown, mildly sick (possibly with Covid with slightly extra fatigue for 3 weeks), but had everything I needed. It rejuvenated me and helped me come a little further into my own after not having been on a multi-day driving adventure in 20 years. I was able to stay for an additional month while the lockdown lasted and to go to the beach everyday. I was fairly tired from the intensity of Covid and it was not a logical outing – but my body did okay and it fed my soul.

#3 Change How You Eat

Changing how you eat may be the single most effective tool you try. Given how nurturing, comforting and pleasurable food can be, however, it can also be one of the most difficult. If you’re thinking about making just one change and aren’t quite sure where to start, this is one of the tools you might want to try first.

The following is an excerpt about how it took me 10 years to finally try significant dietary changes. It was a game changer:

Some years ago I made a drastic change to my diet after an explosion in symptoms and food intolerances. I’d been trying to manage my health with a good diet (lots of fruit and veggies, meat because it made me feel better, and trying not to give in to my sweet tooth too much for sugary desserts). But when  my symptoms continued to worsen, I finally acknowledged that my moderate approach had failed. I’d been slow to incorporate major dietary changes into my life despite all the evidence and once I made big changes, I started experiencing improvements with certain symptoms that I had for many years (from this blog post).

Dietary changes affect epigenetics, reduce inflammation and can calm the nervous system.

They can change the body’s environment to make it less acidic and less hospitable to cancer. Low carb ways of eating can provide less food for infections and thus help combat the effects of infections in unanticipated ways.

Figuring out which diet works for you may be more about you and your preferences than about your particular illness. People have healed from all kinds of diseases using entirely different dietary approaches for the same disease.

2 Common Elements to Implementing Dietary Changes1

1. The first common element is that all of the dietary approaches I know of for healing chronic illness eliminate sugars and processed foods. This means stopping all desserts such as cakes, pies, cookies, ice cream, muffins, cinnamon buns, and probably also stopping cereal, bread and the like.
2. The second element is to give it 30 days to see what happens. 30 days gives your changes time to take effect and your body a chance to begin to shift and respond. 30 days gives you a specific time period to stick with it in the event your body goes through detoxification symptoms such as headaches, nausea and other uncomfortable symptoms that can happen when we make big dietary changes. Even more importantly, 30 days gives you time to see whether a dietary change makes any difference. After 30 days you can decide where to go from there, such as whether to try another 30 days or a different way of eating.

There are many dietary approaches to choose from, many of which contradict conventional allopathic recommendations, which are turning out to reflect only a limited view. Consider some of the following options as examples:

• paleo
• autoimmune paleo
• GAPS
• body ecology diet
• low carb high fat
• low fat without going too high carb
• zero carb
• ketogenic
• juicing
• and many others

When wondering which direction to go, check in with yourself.

What makes you feel better? Do you love meat? Does the density of meat make you feel more grounded? Energized? Calm? Do you have a strong preference for vegetarian foods? Maybe you hate fat? Or maybe you crave fat in the addicted way some of us crave sugar? Does eating fat make you feel better? Use your preferences to pick.

Read about different diets and see what appeals to you.

There is evidence from entire populations, such as the population of Iceland, showing for example that eating a meat and fat only diet can be very healthy and supportive in contrast to the current dictum against them. On the other hand, meat and fats may not be a good fit for your particular metabolism and state of your physiology. This is why intuition is an important tool to use.

If you can’t tell, start with diets that have helped people with the same or similar chronic illnesses.

Then start there. There doesn’t seem to be a right or wrong way, just ways that feel like a good fit for you and that you can experiment with for 30 days at a time to settle into a direction that feels good to you.

Stories of improvement and recovery from chronic illnesses of all kinds abound in the literature.

My Story and Covid Update

Once I finally made big changes to my way of eating after 10 years of symptoms, my symptoms became much less intense and less frequent. This helped me feel calmer, less stressed, and more optimistic. It was also encouraging to feel any kind of progress.

Realizing there were things I could do myself in healing chronic illness in my own life helped me feel more capable. It gave me more choice. I realized I wasn’t powerless. I gained the courage to do and try and experiment more. It also became easier to use other tools, such as to take daily walks.

I spent more than 2 full years on the GAPS diet and then 2 years on a ZeroCarb diet. Both helped with my symptoms but not with my food intolerances. It was after setting boundaries with my father, however, that my food intolerances resolved. I hadn’t even realized I needed to set these boundaries until a series of trauma therapy sessions. This was another realization of just how important it is to recognize and heal trauma in as many ways as we can while you’re doing other things too. It’s a process.

In the 2 years since my food intolerances shifted, I’ve been gentle with my body, worked with my fears of getting symptoms when eating things I couldn’t tolerate for many years and my symptoms have been mild and decreasing. I’ve also begun allowing myself to let go a little. My symptoms continue to remain stable or improve.

I feel best when I start my days with a “clean” (no carb) dense breakfast. I’ve settled into an easy routine of baking chicken with a vegetable. No muss, no fuss, no planning, and my body’s happy.

During the pandemic I have not gone back to a particular way of eating even though it might help my body be a little less tired. This is in part because my symptoms have not been too severe. It’s also that I’ve cut myself some slack to eat carbs and desserts on occasion because I’m tired of using will power. I’m working instead on not reacting to the little symptoms I occasionally have such as a little mouth dryness.

See my December 2020 post on How I Overcame Years of Severe Food Intolerances

#4 Incorporate Mindfulness

Mindfulness is the glue for me. It is the underpinning that guides my work with any and all of these tools.

Mindfulness has to do with focusing your awareness on the present moment and paying attention without judgement or blame. In mindfulness you also invite curiosity and self compassion.

Together with intuition, mindfulness has been one of the most useful tools I’ve found through the years. Paying attention to impulses, listening to intuition, and trusting what I crave are all supported by being mindful of the moment.

Observing sensations and emotions can help identify patterns and reactions in your day-to-day life. For me, overdoing it increases my fatigue so I’ve gradually learned where my limits are and how they change every day.

Paying attention has been empowering, lead me to different ways of thinking about chronic illness in my own life and in general, introduced me to research that supports healing chronic illness in all kinds of ways I never imagined when I was a family doctor, and helped me experience new ways of being with my health and symptoms. Mindfulness is an important for all of us, whether we have a chronic illness or not.

Mindfulness also involves awareness in which you hold curiosity and nonjudgment as you observe your day-to-day life, symptoms, flares, sensations and other experiences as they come up. This helps identify triggers, gain a context for making sense of symptoms, and work with symptoms in new ways rather than getting fully caught up in fear, frustration or the pain of symptoms – at least more of the time.

Mindfulness is an ongoing practice.

It is a practice in not reacting. This is one way to diminish the strength of cell danger responses (CDR) and nervous systems pathways caught in states of survival. By not reacting (or reacting less and less with time), we stop reinforcing CDR pathways. This helps weaken them so that other healthy physiological processes can gain traction instead.

Covid Update

During the pandemic mindfulness has remained a primary resource. I have been acknowledging and focusing on what is going well in my life as best I can as a way to counterbalance all that is not right in the world. I often get pulled by the distress around me. I allow myself to feel the feelings and then, when I remember, I bring my attention to where I am in this moment. To what I can do. To what I have, to beauty in my space such as the dappled sunlight or the rose in my garden. To the support in my life, such as the presence of my husband David, someone with a similar deep philosophy about health and healing chronic illness.

I’ve also continued to work with my emotions of fear that preceded covid (described in covid post #1 and post #2) and that feel like a phase of my healing from chronic fatigue even though it’s uncomfortable. I’ve continued to observe my body’s impulses to immobilize (part of my freeze response, which strengthened a little with covid). I note that this fatigue and lack of desire to do much at times is a physiological process in my body. It is a threat response still defaulting to freeze. But it remains less intense than in the past, which is an encouraging sign of not only progress but also resilience.

In this perspective, I continue to remind myself that my symptoms are not my fault. I continue to make room for not trying to “get rid of” them, push through them, or will power my way through as I have in the past. It means recognizing that this state of not wanting to do things is not fully based on the present, not fully “real” and therefore something to observe from a place of curiosity. I’ve made room to slow down despite an underlying drive to keep going (my fight/flight response), even if it’s hard at times.

#5 Connect to Something Bigger than You: The Spiritual

Having a connection to something larger than ourselves that is nonjudgemental, nonblaming, loving and supportive helps with healing chronic illness.

It helps to know you are not alone. Sometimes this has to happen through imagination. Sometimes it’s in more concrete ways.

Maybe you believe in a named or nameless God, a particular religion, prayer, Mother Earth, intuition or Soul, or that life matters and that black lives matter, or that we are here to learn, love and grow.

Maybe you create an alter by covering a cardboard box with a piece of fabric and adding a candle so you have a place to be and focus.

You may find support in attending mass online these days or in person when it’s possible, joining a Buddhist meditation group, experiencing community through a free online webinar or summit, spending time in nature, attending to a potted house plant, or having a regular spiritual practice such as forgiveness or prayer, gratitude, or learning to love yourself.

This practice makes it easier for your nervous system to access states of calm, ease and feeling supported.

#6 Do it for Oxygenation Rather than Exercise

When I was bedridden from chronic fatigue one of my health professionals recommended that I start walking in order to help my body oxygenate. It was the first time someone had recommended activity with a different objective than doing it for exercise, which always caused exacerbations of my already severe symptoms.

I was surprised to learn that if I paced myself and didn’t go too far, it didn’t make me worse. Initially, I went on walks based solely on trust and listening to myself to not overdo. I used will power to go even when I had trouble sitting up or standing. As long as it didn’t make me worse, I was willing to keep at it.

Eventually,  I began to feel a little better during my walks and afterwards. It reduced my restless leg symptoms at night. It felt good to get outside. I sometimes brought my camera. I got to be in Nature and sit by Little Stream.

Walking has since become a part of my daily routine. It has gradually become energizing and invigorating. This practice is not about quantity or increasing your capacity as much as it’s about adding a component that gives your body some oxygen. Movement. Something that may enable it to work a little better.

Oxygen helps your mitochondria and other cells to function better.

Covid Update

My body has gained the capacity to bounce back more quickly, easily and fully. If I walk until I’m tired, for example. or allow myself to get overtired instead of paying very close attention to how far I should go, I still recover. It’s another sign of progress I remind myself about.

When I was in Oregon during the lockdown I had access to an almost always deserted beach and was able to continue my daily walks. I often stayed out for one or two hours, even on stormy days. I sometimes came home exhausted but it was liberating and energizing in so many ways. My body recovered with each of these too, which gave me the input I needed to know whether I could continue.

Back in Colorado I sometimes skip one or both of my daily walks since missing out no longer affects my health or sleep in negative ways as it used to. Walking continues to feel good to my body and mental health, however, so I usually go out every day.

#7 Connection

Difficulty connecting to yourself or others is a common effect of trauma, which can make us feel unsafe and lose our sense of self. It’s not your fault. It’s also something that can shift and heal with time. It’s something many of us are feeling during these times when there is so much emphasis on differences and a highlighting of inequality and its serious and unacceptable effects in our society.

One name for the branch of the nervous system that is capable of regulating, controlling and suppressing states of fight, flight and freeze when they aren’t needed is the Social Nervous System. It’s because our brains and nervous systems do better when we have some kind of supportive connection(s) in our lives. So #7 is about resources. In contrast to #1 (making room for resource and pleasure), connection is more specifically about the relationship(s) and communities you have in your life.

Relationship can be with family, friends, a spouse, support group or community.

Connection is specifically about relationships that lift you up, make you feel better, feel supported, or that help you be who you are and feel good about who you are. These are big “C” connections (vs little “c” connections.)

Some of us are more introverted or inspired and resourced through solitude. Our relationships may be with nature and things rather than people. These relationships also support health.

Inviting relationship with nature might mean supporting your love of being outdoors by making time to get out, taking little hikes, or simply sitting at a beach or under a tree or next to your orchid. It can be about a relationship to a hobby or craft, or some other passion.

Connection also includes cultivating your relationship with yourself, whether through other tools listed here such as mindfulness, following your impulses or learning to love and value yourself.

If loving who you are or being okay with yourself is a challenge for you, then learning to love yourself may be something deep that is critical to work with on your journey of healing chronic illness.

It’s hard to feel loved by others or to feel supported if you don’t feel love for yourself on the inside. This kind of pain often stems from adversity in early relationships, such as with parents, grandparents or other primary caregivers in which the connection was not sufficiently nurturing, comforting, connecting or safe. You may have been criticized, shamed or judged for being who you were.

Having a chronic illness is another type of trauma that can diminish our relationship with ourselves and with our bodies or make us feel despair, self blame or hopelessness.

All of the tools listed here, as well as therapies for working with attachment and other types of trauma and the nervous system (below in #9 and #10) can help with coming more into connection with yourself and with others.

Covid Update

An interesting experience for me in my healing journey with chronic fatigue has been to find that I am quite a home body who craves solitude and time to myself.

For years I was constrained by my inability to leave the house with much ease, interact with others, spend time with friends or family, or even have conversations – all because of exhaustion.

Once I started having more energy, I felt self judgement about my impulses to continue to spend time on my own. I wondered if I needed to support and strengthen my social nervous system in more active, overt ways and to get out, spend more time with friends, and connect often instead of “isolating.”

Through the process of mindfulness and curiosity, I am learning that, for now, this is where I am. I don’t know if this is WHO I am or if this is simply the state of my social nervous system and capacity at this time.

I note that my social nervous system is deeply sustained through my relationship with David as well as with quiet time and relationship to things and nature. I give myself permission to experience connection through my blog and by writing and “BE-ing” in ways that are satisfying for this phase of where I am.

I no longer use the term “isolating,” which has judgement built into it.

#8 Include a Mind Body Practice

There are many mind body practices such as yoga, yoga nidra (see one person’s experience in the comments to this post below), Tai Chi, Chi Kung, and meditation. As with the other tools, it’s about what YOU are interested in or drawn to. I’ll talk mostly about meditation because it’s commonly discussed, often encouraged. It can also be a potential trigger for many of us with chronic illness, as it’s been for me.

Meditation as well as mindfulness practices (see #4) can influence how our genes are read and how they function ⁽¹⁾Kaliman, P., et al. 2014. Rapid changes in histone deacetylases and inflammatory gene expression in expert meditators. Psychoneuroendocrinology 40: 96-107.

Meditation helps calm the nervous system, strengthen the ventral vagus (social nervous system), and has been found to increase rates of healing during treatment among many, many other positive effects ⁽²⁾Kabat-Zinn, J. (2013). Full Catastrophe Living: Using the wisdom of your body and mind to face stress, pain and illness. New York, Bantam. Here’s an example from the National Council on Aging (NCOA) about how meditation can help with sleep apnea, including by helping adjust to the use of CPAP.

Like many people, I have had difficulty with meditation.

This can occur when your nervous system is not yet able to self-regulate well or do so with ease, or settle itself down on its own.

We learn to self-regulate – cope with difficult emotions, calm ourselves down, settle and ground in our bodies –  through our experiences with our adult caregivers in childhood. Parental support helps a child’s developing nervous system learn and grow. How to be still and not do anything. How to be joyful or exuberant without breaking things. How to cope with big feelings such as anger, grief, excitement.

This trains our own immature nervous systems to manage and be with big emotions that arise such as during meditation, and during stressful and difficult experiences.

Difficulty self-regulating is common after psychological and physical trauma. It is also common with attachment or bonding disruptions and adverse childhood experiences.

Slowing down to meditate, therefore, can be a trigger because it can allow feelings of overwhelm to arise, or feelings of lack of safety or perceptions of threat. Slowing down or meditating can also be difficult when you have a chronic illness that already feels “containing” and limiting, as my chronic fatigue was for me.

The capacity to meditate can increase with time, including by healing chronic illness in other ways and with other mind body approaches. These tools and practices increase our and our body’s capacity for self regulation. For some, meditation itself is doable and helps them learn how to be with uncomfortable feelings without reacting. For others it’s not within our nervous system’s capacities. And that’s okay. It can become more doable with time.

Example of My Story

One approach I used to begin to meditate most recently ago was having “the company” of Jon Kabat Zinn through his talks, his short sitting meditation, 45 minute body scan from the mindfulness based stress reduction clinic (MBSR) at U Mass (here’s a free program available to all online with a different group trained in MBSR), and his book Full Catastrophe Living about the program and how to incorporate it into your own life.

In contrast to sitting on my own, which left me feeling isolated and sometimes more distressed than when I started, having Jon Kabat Zinn’s voice guiding me in mediation felt good.  It was an antidote to an old feeling that meditating, for me, felt like I had to “do it alone,” regulate all by myself,” or “figure it out all by myself.” Hearing his voice helped me feel supported. It conveyed a sense of compassion. It touched me and helped me connect to myself.

MBSR and body scanning may still be too much for many. Listen to your body. Start slow and go slow. Experiment. Try a short amount of time. Be gentle with yourself as you explore what might be a good fit for you.

Find someone among the many leaders in meditation who feels like a good fit for you such as Tara Brach, Pema Chodron, Thich Nhat Hanh, Sharon Salzberg and others.

If meditation is not a good fit, then look into other mind body practices to see if one appeals to you.

Covid Update

I have practiced Tai Chi, meditation and yoga at different times over the years, usually for at least a year each. Right now I am not currently using a mind body practice. I know I can meditate or do yoga on occasion because it can help calm down a symptom. This isn’t the standard way to use them but it works for me for now while my symptoms are no longer severe. I don’t quite have the motivation during the stressors associated with Covid and the times so, given that I’m doing okay, it feels good to do less.

#9 Heal Early Attachment Wounds

The first 8 tools can help your body’s natural resources heal much of the effects of environmental stressors and prolonged cell danger responses.

If they are not enough for you to recover it’s not because something is wrong with you or that you’re doing it wrong or that you are to blame for your illness. It’s because our bodies are complex and so are the lifelong effects of adversity and environmental stressors. It’s also because we don’t fully know how much healing can happen and to what extent. This seems to be the nature of life and being human.

If implementing the first 8 tools are not enough to recover from chronic illness or you want to implement as many tools as possible, then working directly with attachment or “developmental” trauma and other types of trauma (#10) can help decrease states of fight, flight and freeze and the cell danger response that drive symptoms in additional ways.

The nature of the attachment bond between children and their parents affects our nervous and immune systems as well as risk for chronic illness. It also shapes our ability to feel self love, self worth and self compassion. Plus, it shapes our social nervous systems, how they regulate in general and the extent to which they can inhibit fight, flight, freeze and the cell defense response.

Working with patterns that develop as a result of early relationships that might not have been full of connecting, loving, support may therefore also helpful in healing chronic illness.

You can start with other tools such as those listed above and come to this attachment work if the others are not sufficient to help you recover to the degree you would like. Or you can incorporate this approach from the beginning and combined it with the others.

A benefit of healing attachment wounds is that it also improves the relationships we have as adults such as with spouses, colleagues, children, friends and family. It also helps us connect more with ourselves.

This enables us to experience more connection and joy with friendships, to have greater flexibility and empowerment in our daily interactions in work and elsewhere, and to experience greater trust, support and depth in our most intimate relationships. As with the other tools listed here, effects are additive and keep growing our sense of feeling supported, held, and cared for.

Healing attachment wounds and developmental trauma, which I refer to as adverse childhood relationship experiences (ACREs), also supports, strengthens and repairs deficits in our social nervous systems.

Find out more about ACREs in this blog post, about books for healing ACREs in this  post and look at a list of directories to help you find a therapist in this post.

Learn more about attachment in the documentary website for Wrestling Ghosts, in Dr. Dan Siegel’s book Parenting from the Inside Out, and gain more tools for healing such as The Complex PTSD Workbook: A Mind-Body Approach to Regaining Emotional Control and Becoming Whole by friend and colleague Arielle Schwartz, Ph.D. who is also a trauma and EMDR therapist.

Attachment Trauma and Covid

The uncertainty in the world right now is a trigger for many of us and stimulates old, unresolved traumas. This includes our wounds from attachment experiences.

The almost universal practice of social distancing is a very real and critical loss of social connection, community, safety and support for many. It’s an act of physical distancing that has a side effect of reducing social connection in the forms most people know and need. It is a natural stressor and trigger, especially for the most vulnerable in a society with high levels of inequality and injustice.

This is a time to connect in the best and most creative ways you can if social contact is a resource for you. Whether through phone calls, zoom, meeting within distances that work for you, writing letters the old way or in other ways.

Periods of high intensity and stress also often decrease our capacity for new information. This is a normal response when our minds, emotions and bodies are busy managing safety and threat responses. Consequently, it can be important and helpful to reduce input of things and interactions that may seem connecting but that are more often triggering (news, social media, TV, connections that feel stressful or that don’t feel supportive etc).

Covid Update

I have been feeling more connection during this period with David, who is my best friend. Someone with whom I can discuss anything and everything. This is the result of a lot of work on my attachment trauma, including last year when I went to Europe for Family Constellations. We’ve been doing a lot of work to process what arises for us during these times, since we both feel more stressed than usual and can get triggered more easily. As a result we also feel more weary from the extra effort, which leaves us with less margin for “extras.”

I have also been getting connection with family and friends, sometimes by email, sometimes by phone. I’ve been feeding my social nervous system by sitting on my porch and being with my garden, or having quiet time with a good book. I have also been taking in connection with the bigger world, such as from your lovely comments on the blog and the inspiring stories you share about what has worked for you or helped you :-).

The other thing I have been doing is honoring my decreased ability to take in information, even the good stuff, during these times to reduce the stress in and on my system. I spend little time on social media these days, and read news headlines once or twice a day rather than watching news or scanning it often.

#10 Address the Effects of Trauma on Your Nervous System

For me, recognizing the traumas from my past gave me new options.

Even though I never thought I had experienced trauma of any kind, I gradually realized that many “little traumas” had occurred in my past. Because our modern society has yet to recognize the many types of subtle trauma that impact health nor to fully acknowledge many of the effects of overt forms of trauma, including racism, many of us do not recognize the trauma we’ve experienced.

The more we learn about trauma, the more we recognize it from our own lives, the more we gain options and tools for healing.

Working with my nervous system from a trauma perspective has been the single most important tool for healing chronic illness, for me, out of all of these tools.

It has given me a context for understanding my symptoms, helped me reduce them, given me tools to prevent and work with flares, empowered me to say no, and so much more.

Our increasing understanding of trauma explains that adverse events alter how our nervous systems function by disengaging the “social nervous system” branch that regulates, calms and supports health.

Trauma instead enlists and fosters states of fight, flight or freeze. This includes the stress response and can also be expressed specifically as a chronic illness.

To restate what is often and commonly misinterpreted, this isn’t because it’s psychological or all in your head, but because the effects of trauma alter our genes to influence our biology, physiology, immune system, guts, hormones as well as our emotions and our ability to think. Trauma also affects us through generations.

Contrary to our cultural mantra to just “push through,” “pull yourself up by your bootstraps,” or “bury the past and move on,” we cannot just leave trauma in the past. Like an abscess, it grows and festers and can cause physical and emotional pain or illness.

If you’re experiencing a chronic illness and nothing else you’ve tried has helped or been enough to begin to improve or recover, then work with your nervous system from a trauma point of view.

Working with different types of trauma helps heal the nervous system. It also helps with symptoms of chronic illness.

Working with trauma is a vastly under-recognized tool for working with chronic disease even though the research is abundant. That’s part of why it is such a strong focus of my blog.

You can work with general trauma or heal very specific types of trauma. This can be through individual work and it can be through group work or as part of a community. You’ll find a list of approaches with links to find therapists in my therapies post. You’ll also find a list of books to learn more about trauma and work with it yourself as one place to start.

Healing from trauma includes approaches for working with specific types of events and experiences. The posts below present the science explaining how effects are not psychological.

Risk for disease and symptoms is affected by:

• adverse babyhood experiences (ABEs): during pregnancy, birth and infancy (infections, illness in our mothers, complex births such as forceps or cesarean births, being born prematurely and more)
• adverse childhood experiences (ACEs+)
• multigenerational trauma
• institutional trauma (discrimination such as racism, sexism, homophobia and much more
• You can read about or watch a video of what trauma therapy and recovery can look like showing how Cesar Milan works with a dog named Kane.
• stressful and traumatic events can trigger the onset of chronic illness and other symptoms

Covid Update

Many of us, whether healthy or living with chronic illnesses, are experiencing more symptoms, new symptoms, or more severe symptoms during the pandemic. The trauma perspective helps make sense of this. It also takes away self blame and fear and gives us tools and options, even if we can only implement some of them in creative little ways.

What I’ve learned about trauma through personal experiences, with an ongoing mindfulness practice, as a result of trauma therapy, and from the research continues to help me with healing my disabling chronic fatigue even during the pandemic.

While my fatigue has increased somewhat during covid and I’m back to needing naps some times for the first time in a few years, what I’ve learned about trauma helps me. It helps me recognize that this is an intelligent even if not fully adaptive response to the stress and sense of threat in the world. It helps me recognize that my body has gained resilience from all the tools I use on a daily basis even during a period as intense as this one.

My body also has more capacity to be normal (I didn’t really know if normal was “a real thing” until now). Normal for me means that I no longer have to do or use all my tools, such as eating in a special and restricted way all the time, even as I know that I can turn to diet if my system needs more support.

#11 Titration

The idea of titration is about going more slowly and doing less when experiences are more intense, stressful or difficult. It’s about making room for our systems by giving them more time and space to integrate and adapt. With enough time and space and support, many things are not as overwhelming or difficult.

I learned about this in my somatic trauma trainings such as Somatic Experiencing (SE), where they refer to this process as “Slower is Faster” and “Less is More.”

A key tenet in trauma work is that working with resources and trauma is about paying attention to the innate capacity of our own bodies and nervous systems and physiologies to be with what arises. Our bodies are actually really good at swinging back and forth between stress and resource as a way of digesting experiences if there is enough time and the pace is spacious enough.

As an example. with enough time and space and support, we can more easily remember and take the time to check in to the present moment. Then we can notice that we are no longer caught in a past trauma that we might still be reacting to. We can more easily come up with ideas for coping or make decisions about what to say or do. We can reframe something in a more helpful context.

Covid Update

I got my teeth cleaned recently for the first time in a year. I had delayed going due to Covid and also because I don’t love getting dental work, even a simple thing like a cleaning. But I chipped a tooth and it was time to go in.

As I’ve done for years, I used my tools to specifically orient to my environment in the present moment, checking in to the reality of the supportive atmosphere, the picture of my dentist’s dog on the ceiling, the picture of the pumpkin on the wall, and the fact that I was okay in that moment even if my body was tensing.

The hygienist then did something new. She paused every once in a while and took the instruments out of my mouth. Each time she did this it gave me the chance to catch my breath, realize I’d tensed up, and to let go a little.

During one of these lovely pauses, something new arose that I don’t remember ever experiencing with a cleaning.

I felt a spontaneous appreciation for how good it felt to be getting the tartar off my teeth.

This was not something I was consciously choosing to think or believe. It was something that bubbled up from deep inside. It came from the health of my system.

This appreciation came with words and a reframe of the situation that popped into my head. Instead of enduring, I felt as though I was getting a gift – a “teeth and gum massage.”

This is an example of a fleeting, easily missed indicator of resilience and healing. It’s something that is effortless because it comes from our system doing the work outside of our awareness. This is how healing happens. Sudden, spontaneous, and often unexpected.

While at the dentist I can repeatedly tell my anxious self that all is okay and consciously work to pay attention to soothing pictures or music, it is very different to find a spontaneous, positive, present moment perspective emerge up from within. This is how our systems adjust when we give them enough room to do so.

This is why spacing and pacing is a tool I had to add to this list.

There is a deep underlying process in how we help our threat responses “unhook” from old patterns in our nervous systems. It supports our body’s ability to respond with more choice, rather than through activation and reactivity. It shifts our attention to the positive. It comes with more ease, just as our systems are designed to do.

Related Posts

Posts With Resourcing Tips

Introducing Polyvagal Theory

Other Free eBooks

Trauma and Chronic Illness: + 11 Characteristics that Can Make Sense of Symptoms (Summary of the Science)

18 Stealthy Ways to Act Out and Heal Fight, Flight, Freeze and Disease

Making Time for Chronic Illness Resources (Tips for Healing Chronic Illness)

Essential Guide to Chronic Illness, Trauma and The Nervous System: Keys to Quelling the Volcano

9 Tips for Inviting Safety: Calming Fear in the Time of The Coronavirus (Covid-19 Post 1)

Comfort, Chronic Illness and Covid-19 (How Comfort in the Little Things Helps and Heals) Covid Post 2

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